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The lack of experienced ophthalmologists limits the early diagnosis of retinal diseases. Artificial intelligence can be an efficient real-time way for screening retinal diseases.To develop and prospectively validate a deep learning (DL) algorithm that, based on ocular fundus images, recognizes numerous retinal diseases simultaneously in clinical practice.This multicenter, diagnostic study at 65 public medical screening centers and hospitals in 19 Chinese provinces included individuals attending annual routine medical examinations and participants of population-based and community-based studies.Based on 120 002 ocular fundus photographs, the Retinal Artificial Intelligence Diagnosis System (RAIDS) was developed to identify 10 retinal diseases. RAIDS was validated in a prospective collected data set, and the performance between RAIDS and ophthalmologists was compared in the data sets of the population-based Beijing Eye Study and the community-based Kailuan Eye Study.The performance of each classifier included sensitivity, specificity, accuracy, F1 score, and Cohen κ score.In the prospective validation data set of 208 758 images collected from 110 784 individuals (median [range] age, 42 [8-87] years; 115 443 [55.3%] female), RAIDS achieved a sensitivity of 89.8% (95% CI, 89.5%-90.1%) to detect any of 10 retinal diseases. RAIDS differentiated 10 retinal diseases with accuracies ranging from 95.3% to 99.9%, without marked differences between medical screening centers and geographical regions in China. Compared with retinal specialists, RAIDS achieved a higher sensitivity for detection of any retinal abnormality (RAIDS, 91.7% [95% CI, 90.6%-92.8%]; certified ophthalmologists, 83.7% [95% CI, 82.1%-85.1%]; junior retinal specialists, 86.4% [95% CI, 84.9%-87.7%]; and senior retinal specialists, 88.5% [95% CI, 87.1%-89.8%]). RAIDS reached a superior or similar diagnostic sensitivity compared with senior retinal specialists in the detection of 7 of 10 retinal diseases (ie, referral diabetic retinopathy, referral possible glaucoma, macular hole, epiretinal macular membrane, hypertensive retinopathy, myelinated fibers, and retinitis pigmentosa). It achieved a performance comparable with the performance by certified ophthalmologists in 2 diseases (ie, age-related macular degeneration and retinal vein occlusion). Compared with ophthalmologists, RAIDS needed 96% to 97% less time for the image assessment.In this diagnostic study, the DL system was associated with accurately distinguishing 10 retinal diseases in real time. This technology may help overcome the lack of experienced ophthalmologists in underdeveloped areas.

Background Blepharochalasis is a rare eyelid disorder but eventually leading to destructive eyelid deformation. Until now the clinical and epidemiological data are unavailable. This study aimed to report the manifestations, epidemiological characteristics and surgical strategy of a large series of blepharochalasis patients with long-term follow-up. The prognosis of different clinical deformities was also investigated. Methods This was a retrospective cohort study, including consecutive patients diagnosed with blepharochalasis in a single center. Blepharoplasty and other surgical approaches were performed according to manifestations, after a 2-year quiescent period with no recurrent attacks and exacerbation of lesions. Prognosis after surgery was recorded. Results A total of 93 patients, with a mean age of 30.77 ± 14.04 (range: 9.00–70.00) years were included. Of all those 93 patients, 72.04% were females (67, P = 0.02). The mean follow-up was 5.29 ± 2.07 (range: 3–10) years before surgery, and 2.07 (range:1.54–4.22)years follow-up after surgery. The mean age of onset of blepharochalasis symptoms was 10.09 ± 3.32 (range: 5–16) years, and 83.87% patients got symptoms in puberty. With an average of 5 times per year, the mean duration of each acute attack was 28.12 ± 1.01 (rang: 2–192) hours. The mean duration from the onset of acute attack to the quiescent stage lasted for 7.33 ± 2.05 (range: 4–10) years. Most of the cases (88, 94.62%) had more than one manifestation at the end of the last follow-up before surgery. Ptosis (48.39%) was the most common deformity. Followed by lacrimal gland prolapse (44.09%), canthal angle deformity (29.04%), lower eyelid retraction (17.20%). After surgery, the functional and cosmetically acceptable results were achieved in all patients except for overcorrection in 5 (11.90%) patients with ptosis. The lacrimal gland prolapse recurred in two (4.00%) patients at 29 and 36 months after surgery. Conclusions Blepharochalasis is rare but mostly occurred in adolescent females. The process from the onset to the stable stage usually lasted for about 7 years, which might be associated with the onset of puberty. Surgical management of clinical manifestations after at least 2-year follow-up period of quiescence would be appropriate in order to observe a great plastic effect, low overcorrection and recurrence rate.

Background: Blepharochalasis is a rare eyelid disorder but eventually leading to destructive eyelid deformation. Until now the clinical and epidemiological data is unavailable. This study aimed o report the manifestations, epidemiological characteristics and surgical strategy of a large series of blepharochalasis patients with long-term follow up, the prognosis of different clinical deformities was also investigated. Methods: This is a retrospective cohort study, included consecutive patients diagnosed with blepharochalasis in a single center. Blepharoplasty and other surgical approaches were scheduled according to the various manifestations, after a 2-year quiescent period with no recurrent attacks and exacerbation of lesions. Prognosis after surgery was recorded.Results: A total of 93 patients, with a mean follow-up of 5.29±2.07 (range: 3-10) years before surgery, and 2(range:1-4) years follow-up after surgery were included. Of all those 93 patients, 72.04% were females (67, P=0.02 ). The mean age of onset of blepharochalasis symptoms was 10.09±3.32 (range: 5-16) years, mostly (83.87%) consisted with the onset of the puberty. With the average of 5 times per year, the mean duration of each acute attack was 28.12±1.01 (rang: 2-192)hours. The mean duration from the onset of acute attack to the quiescent stage lasted for 7.33 ± 2.05 (range: 4-10) years. Most of the cases (88, 94.62%) had more than one manifestation at the end of the last follow-up before surgery. Ptosis (48.39%) was the most common deformity. Followed by lacrimal gland prolapse (44.09%), canthal angle deformity(29.04%), lower eyelid retraction(17.20%). After surgery, the functional and cosmetically acceptable results were achieved in all patients except for overcorrection in 5 (11.90%) patients with ptosis. The lacrimal gland prolapse recurred in two (4.00%) patients at 29 and 36 months after surgery. Conclusions: Blepharochalasis is rare but mostly occurred in adolescent females. The process from the onset to the stable stage usually lasted for about 7 years, might be associated with the onset of puberty. Surgical management of clinical manifestations after at least 2-year follow-up period of quiescence would be appropriate in order to observe a great plastic effect, low overcorrection and recurrence rate.

Different patterns of retinal arterioles and venules in the fundus images form an important metric to measure the disease severity. Therefore, an accurate classification of arterioles and venules is greatly necessary. In this work, we propose a novel network, named as the dual Deeply-Supervised Network (dual DSN), to classify arterioles and venules on retinal fundus images. We employ the U-shape network (U-Net) as the backbone of our proposed model. Our proposed dual DSN produces an auxiliary output of the network at every scale, which generates a loss by comparing to the manual annotation. The losses in the encoding path of dual DSN regularize the low-level features, while those in the decoding path of dual DSN regularize the high-level features. In sum, such losses in dual DSN form dual supervision to the backbone U-Net and capture the multi-level features of the input image, which improves the classification of retinal arterioles and venules. The experimental results demonstrate that the proposed dual DSN outperforms the previous state-of-the-art methods on DRIVE dataset with an accuracy of 95.0%.

Discovering a relationship between axial length and vitreous volume would be helpful since the axial length is easier to measure than magnetic resonance imaging (MRI) parameters. This study aimed to analyze the topography of human eyes with pathological myopia through volume rendering images by high-resolution 3D-MRI and to establish a model to estimate the vitreous volume. This was a retrospective, non-randomized, controlled study of patients evaluated at Tongren Hospital from July 7, 2007 to December 12, 2018. The controls were emmetropic volunteers. All participants underwent ophthalmic examinations. Axial length was measured with an IOL Master. High-resolution 3D MRI and volume rendering was utilized for all the eyes. Logistic regression was used to establish a model to predict the vitreous volume. A total of 280 emmetropic eyes and 290 eyes with pathological myopia were included. Males represented 60.7% and 65.5% of the individuals. The mean axial lengths of those two groups were 23.1 ± 0.8 mm (95%CI: 22.7–23.4 mm) and 28.3 ± 2.2 mm (95%CI: 27.5–29.2 mm), respectively (P

Traumatic retinal detachment is caused by blunt contusion, and most of them starts from ora serrata dialysis. Intraocular foreign body usually associates with open-globe injury, for eyes with intraocular foreign body, the nature of the foreign body determines the clinical behavior. Tractional retinal detachment caused by trauma is one of the main causes of blindness. Endophthalmitis is a rare but serious complication, but Retinal detachment associates with endophthalmitis is very common.

Optic disc melanocytoma is a rare, benign, dark brown- to black-colored tumor that usually occurs on or adjacent to the optic nerve head. Papillary capillary hemangioma is one possible manifestation of ocular capillary hemangioma and may occur sporadically or as a single or first manifestation of von Hippel-Lindau disease. Retinal hemangioma includes three kinds of diseases: retinal capillary hemangioma, retinal cavernous hemangioma, and retinal plexiform hemangioma. Retinoblastoma is the most common malignant tumor in eyes of infants. Choroidal hemangioma is a benign, relatively rare hamartomatous tumor. Choroidal melanoma is the most common primary malignant tumor in adults. Uveal tumors primarily which occur in the iris can also involve the ciliary body, such as iris melanoma, iris neurofibroma, iris nerve sheath tumor, iris cyst, etc. Choroidal melanoma can also involve the ciliary body. Metastatic carcinoma to the choroid is common, with the breast and the lung as frequent primary sites; secondary exudative retinal detachment could occur in the surface of the tumor.

To investigate the characteristics of bilateral rhegmatogenous retinal detachment (RRD) in a hospital-based population.Six hundred and three patients diagnosed with bilateral RRD in the Beijing Tongren Hospital between January 2000 and January 2014 were identified and included into the study. The clinical features including the age when retinal detachment occurrence, time interval between the occurrence of the bilateral RRDs, predisposing characteristics such as myopia, trauma, et al. were recorded by a chart review.Out of 8 283 patients treated for primary RRD in the study period, (7.30±2.45)%(603 patients) developed a RRD in the contralateral eye, with a mean age of (30.76 ± 15.31)years (range: 2-68) when the first RRD occurred. 4.8% of the patients primarily presented with a simultaneous bilateral RRD. Most RRD occurred firstly in the left eye (52.90%). Compared with the follow eye, the first RRD occurred with more macula detachment (P=0.03, OR: 1.59, 95%CI: 1.04-2.45) and retinal proliferation (P=0.04, OR: 1.57, 95% CI: 1.02-2.42), the visual outcome was more worse. Mean interval between the bilateral RRDs was (3.73±7.05) years (mean±standard deviation, range: 0-56 years) The younger, more severe symptoms of the firstly occurred RRD, the shorter interval between the bilateral RRD. Time interval between the bilateral RRD was shorter in those RRD firstly occurred with macula detachment, giant tears, horse-shoe tear, located in the temporal superior region, or with retinal degeneration. Compared with highly myopic eyes, the interval between the bilateral RRD were shorter in moderately myopic eyes.For patients newly diagnosed with RRD, regardless of age, are required to a lifelong follow-up for the contralateral eye, especially within one year. Patients who were young, with heavier symptoms, low to moderate myopia or present with retinal degeneration, should be closely followed up in a short time after the first RRD occurred.

To investigate the subfoveal choroidal thickness (SFCT) and its relationship to associated diseases, including diabetes mellitus, diabetic retinopathy, and glaucoma.The population-based cross-sectional Beijing Eye Study 2011 included 3 468 individuals with a mean age of (64.6 ± 9.8) years. A detailed ophthalmic examination was performed including spectral-domain optical coherence tomography with enhanced depth imaging model (EDI SD-OCT). 246 patients with diabetes and 128 patients with glaucoma were enrolled in the study. Statistical analysis was performed by SPSS 20.0 to examined the mean values of SFCT and the prevalence rate of associated diseases; an univariate and multivariate linear regression to analyse the relationship between SFCT and ocular or general factors.Mean SFCT was (253.8 ± 107.4)µm. In multivariate analysis, SFCT was significantly associated with younger age (b = -4.12, P0.001), shorter axial length (b = -44.7, P0.001), male gender (b = -28.5, P0.001), deeper anterior chamber depth (b = 39.3, P0.001), thicker lens (b = 26.8, P0.001), flatter cornea (b = 46.0, P0.001) and better best corrected visual acuity (b = -48.4, P = 0.001). Mean SFCT in diabetes mellitus group was (266 ± 108) µm. In multivariate analysis, SFCT was significantly related to presence of diabetes mellitus (b = 21.2, P = 0.001); but neither presence (P = 0.61) nor stage (P = 0.14)of diabetic retinopathy was significantly associated with SFCT. Mean SFCT in glaucoma group was (201.4 ± 102.4.1) µm. Mean SFCT in glaucoma group was (201.4 ± 102.4.1) µm; for open angle glaucoma, mean SFCT was (210.1 ± 104.7) µm; for primary close angle glaucoma, mean SFCT was (184.2 ± 93.6 )µm. In multivariate analysis, SFCT was significantly associated with close angle glaucoma (b = -32.3, P = 0.04), but was not related to open angle glaucoma (P = 0.44).Mean SFCT was (253.8 ± 107.4)µm. SFCT was increased with age and myopic refractive error; and associated with male gender, anterior chamber depth, lens thickness, flatter cornea , best corrected visual acuity. SFCT in patients of diabetes mellitus was slightly thicker than normal people; but the presence and development of diabetic retinopathy were not related to SFCT. SFCT in patients with close angle glaucoma was thinner than control group; but for open angle glaucoma, SFCT was similar to the normal people.